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Devoted PREMIUM Oregon (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Devoted PREMIUM Oregon (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Devoted PREMIUM Oregon (HMO) in 2025, please refer to our full plan details page.
Devoted PREMIUM Oregon (HMO) is a HMO plan offered by Devoted Health, Inc. available for enrollment in 2025 to people living in Eugene. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that Devoted PREMIUM Oregon (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Devoted PREMIUM Oregon (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Devoted PREMIUM Oregon (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $15.60. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $590.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5900.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The Devoted PREMIUM Oregon (HMO) plan has a $590 deductible for prescription drugs. After the deductible, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, you will pay a $10 copay for preferred generic drugs at a standard or mail-order pharmacy. For standard generic drugs, preferred brand drugs, and non-preferred drugs, you will pay 25% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you will pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Devoted PREMIUM Oregon (HMO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have copays that vary. Emergency services have a copay, and ambulance services have either a copay or coinsurance. This plan also covers primary care, hearing, vision, and dental services, each with specific copays or coinsurance. Additionally, it provides coverage for home health, home infusion, and skilled nursing facility services, with some services requiring prior authorization.
Inpatient Hospital See details
The Devoted PREMIUM Oregon (HMO) plan covers inpatient hospital stays, including services not usually covered by Medicare, with a $425 copay for days 1-4 and no copay for days 5-90. Additional days for inpatient hospital-acute are covered with no copay, while non-Medicare covered stays and upgrades for inpatient hospital-acute are not covered. Inpatient hospital psychiatric benefits are covered with a $425 copay for days 1-4 and no copay for days 5-90, and additional days and non-Medicare-covered stays are not covered.
Outpatient Services See details
Outpatient Services includes coverage for all outpatient hospital services, with a copay between $0 and $525, and observation services with a $425 copay. Ambulatory Surgical Center (ASC) Services have no copay, and outpatient substance abuse services have a $40 copay for both individual and group sessions. Outpatient blood services are also covered, including services not usually covered by Medicare plans.
Partial Hospitalization See details
Partial Hospitalization is covered by the Devoted PREMIUM Oregon (HMO) plan with a $70 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by Devoted PREMIUM Oregon (HMO). Ground ambulance services have a copay between $0 and $285, while air ambulance services have a 20% coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by Devoted PREMIUM Oregon (HMO). Emergency Services have a $125 copay, and Urgently Needed Services have a copay between $0 and $45. Worldwide Emergency Transportation has a 20% coinsurance and a $285 copay, while Worldwide Emergency Coverage and Worldwide Urgent Coverage each have a $125 copay.
Primary Care See details
The Devoted PREMIUM Oregon (HMO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $40-$45 copay, physician specialist services with a $40 copay, mental health specialty services with a $40 copay for individual and group sessions, other health care professional services with a $0-$40 copay, psychiatric services with a $40 copay for individual and group sessions, physical therapy and speech-language pathology services with a $40-$50 copay, additional telehealth benefits with a $0-$40 copay, and opioid treatment program services with a $40 copay. Podiatry services are not covered.
Preventive Services See details
Preventive Services include coverage for Medicare-covered preventive services, annual physical exams, health education, weight management programs, alternative therapies, therapeutic massage, nutritional/dietary benefits, fitness benefits, home and bathroom safety devices and modifications, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a Welcome Visit. In-home safety assessment, personal emergency response system, medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss related to chemotherapy, home-based palliative care, in-home support services, support for caregivers of enrollees, additional sessions of smoking and tobacco cessation counseling, counseling services, and telemonitoring services are not covered.
Hearing Services See details
Hearing services include hearing exams with a $40 copay. Routine hearing exams are covered once per year, and fitting/evaluation for hearing aids is covered with no copay. Prescription hearing aids are covered with a copay between $199 and $499 for all types, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including routine eye exams with a $40 copay, and eyewear with a combined maximum benefit of $1500 every year. Contact lenses, eyeglasses (lenses and frames), eyeglass lenses, eyeglass frames, and upgrades are also covered.
Dental Services See details
The Devoted PREMIUM Oregon (HMO) plan covers Medicare dental services with a $40 copay and other dental services, including oral exams, dental x-rays, and more, with an annual maximum of $1,500. Maxillofacial Prosthetics, Implant Services, and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services, including Medicare Part B Insulin Drugs, are covered. Medicare Part B Insulin Drugs have a $35 copay and 20% coinsurance, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have between 0% and 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by the Devoted PREMIUM Oregon (HMO) plan. There is a 20% coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with 0-18% coinsurance and no copay, Prosthetic Devices with 0-20% coinsurance and no copay, and Medical Supplies with 20% coinsurance and no copay; however, Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a copay between $0 and $95, and lab services with no copay. Therapeutic Radiological Services have a coinsurance of at most 20%, while Diagnostic Radiological Services have a copay of at most $400, and Outpatient X-Ray Services have no copay.
Home Health Services See details
Home Health Services are covered by the Devoted PREMIUM Oregon (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the Devoted PREMIUM Oregon (HMO) plan. The plan does not provide coverage for Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, or Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered, but require prior authorization. For days 1-20, there is no copay, for days 21-47, the copay is $190, and for days 48-100, there is no copay.
Other Services See details
The Devoted PREMIUM Oregon (HMO) plan covers acupuncture with no copay, and also covers Other Services with no copay for preventive services. However, over-the-counter items, meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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